Altered proteome profiles related to visceral adiposity may mediate the favorable effect of green Mediterranean diet: the DIRECT‐PLUS trial

Abstract

AbstractObjectiveThe objective of this study was to explore the effects of a green Mediterranean (green‐MED) diet, which is high in dietary polyphenols and green plant‐based protein and low in red/processed meat, on cardiovascular disease and inflammation‐related circulating proteins and their associations with cardiometabolic risk parameters.MethodsIn the 18‐month weight loss trial Dietary Intervention Randomized Controlled Trial Polyphenols Unprocessed Study (DIRECT‐PLUS), 294 participants with abdominal obesity were randomized to basic healthy dietary guidelines, Mediterranean (MED), or green‐MED diets. Both isocaloric MED diet groups consumed walnuts (28 g/day), and the green‐MED diet group also consumed green tea (3–4 cups/day) and green shakes (Mankai plant shake, 500 mL/day) and avoided red/processed meat. Proteome panels were measured at three time points using Olink CVDII.ResultsAt baseline, a dominant protein cluster was significantly related to higher phenotypic cardiometabolic risk parameters, with the strongest associations attributed to magnetic resonance imaging‐assessed visceral adiposity (false discovery rate of 5%). Overall, after 6 months of intervention, both the MED and green‐MED diets induced improvements in cardiovascular disease and proinflammatory risk proteins (p < 0.05, vs. healthy dietary guidelines), with the green‐MED diet leading to more pronounced beneficial changes, largely driven by dominant proinflammatory proteins (IL‐1 receptor antagonist protein, IL‐16, IL‐18, thrombospondin‐2, leptin, prostasin, galectin‐9, and fibroblast growth factor 21; adjusted for age, sex, and weight loss; p < 0.05). After 18 months, proteomics cluster changes presented the strongest correlations with visceral adiposity reduction.ConclusionsProteomics clusters may enhance our understanding of the favorable effect of a green‐MED diet that is enriched with polyphenols and low in red/processed meat on visceral adiposity and cardiometabolic risk.